By Jenny Westberg, Portland Mental Health Examiner, April 21, 2014

An anti-civil rights bill that purports to fix the “broken mental health system” but would actually gut that system has picked up a new and formidable opponent. Psych Central — and the more than 350,000 Americans it represents – last week came out strongly against HR 3717, the so-called “Helping Families in Mental Health Crisis Act.”

Psych Central joins a chorus of dissenters, including the National Coalition for Mental Health Recovery (NCMHR), a coalition of 32 statewide organizations and others representing individuals with mental illness. Others opposed to the bill include the National Disability Rights Network (NDRN), the National Council on Independent Living, the American Association of People with Disabilities, and the Bazelon Center for Mental Health Law.

NCMHR, NDRN and the Bazelon Center noted that HR 3717 “does not represent the mainstream of national thought, practice and research.”

Pro-coercion, anti-privacy

At the core of the bill, introduced by Rep. Tim Murphy (R-PA) late last year and heard by a House subcommittee April 3, is force and coercion in mental health care. If enacted, HR 3717 would expand the criteria for involuntary commitment and extend the reach of Assisted Outpatient Treatment, which facilitates forcible treatment in the community. NCMHR notes that involuntary outpatient commitment is a high-cost intervention with no evidence it works.

The act would even use coercive tactics against non-patients, such as state legislatures, which would be required to pass forced-treatment laws, whether or not their citizens want them.

It would also decimate personal privacy. Under the bill, if a hospitalized person designated “seriously mentally ill” did not consent to information sharing with their caregiver, their caregiver would automatically be named personal representative and get all the information anyway.

Defunding the defenders

The bill also guts SAMHSA and cripples state Protection and Advocacy organizations created to defend the rights of disabled persons. Locally, that’s Disability Rights Oregon (DRO), which has powerfully acted on behalf of persons with psychiatric disabilities many times. The proposed legislation would silence DRO, slash its funding and prevent it from filing class action suits on behalf of people with mental illness.

Bob Joondeph, DRO’s executive director, called the bill an attack on the hard-won rights established by the Americans With Disabilities Act (ADA), an attempt “to change our country’s mental health policy from encouraging recovery to taking control of others’ lives.”

“The text of the ADA sets out its core goals as equality of opportunity, full participation, independent living and economic self-sufficiency,” Joondeph said. “Among the problems that the ADA was specifically enacted to address are ‘institutionalization,’ ‘overprotective rules and policies,’ ‘isolation’ and ‘segregation.’ But Rep. Murphy…would more likely characterize the real problem as people with disabilities lacking obedience to authority.”

“I can’t and won’t support it”

Beckie Child, a doctoral student and adjunct faculty member at Portland State University, said flatly, “I oppose HR 3717. There are so many problems with HR 3717 that I can’t and won’t support any aspect of it.”

The recent subcommittee hearing repeatedly linked mental illness and violence, but Child noted, “Psychiatry’s ability to predict who will become violent has never been good and it has not improved. The reality is that we cannot predict who will become violent.”

She added, “The reality is that the mental health system is not all that great at engaging people. The only people who will benefit from this bill if it were to become law are psychiatrists and the organizations that provide services to people that are subject to its provisions.“

HR 3717 is not intended to benefit persons with mental illness, according to Psych Central, which explains: “You can kind of tell this isn’t a bill directed at patients and helping patients in the mental health system simply by its name, ‘The Helping Families In Mental Health Crisis Act.’ You see that there — families. Not people with mental illness. This is about helping families deal with a family member who has an apparent mental illness — not about helping the actual people with a mental illness.”

NAMI keeps it blurry

But the most prominent “family” mental health organization, NAMI, has been coy about giving a straightforward opinion on the bill. Chris Bouneff, executive director of NAMI Oregon, referred me to a letter from NAMI National from last December that avoids nailing down a position, with some parts of the bill labeled “positive” and others as “more controversial.” Although several local NAMIs have spoken out for (and less often, against) the bill, Bouneff said, “As this is federal legislation, the national organization is the one that sets NAMI positions with input from NAMI members and state and local chapters.”

Daniel Fisher, M.D., Ph.D., a founder of NCMHR, said the legislation would dismantle evidence-based, voluntary, peer-run services that promote recovery. “These services have a proven track record in helping people stay out of the hospital and live successfully in the community. Because hospitalization is far more expensive and has far worse outcomes than these effective, and cost-efficient, community-based services, this bill would cost more money for worse outcomes,” he said.

“Even worse,” Fisher added, “the bill greatly promotes stigma and discrimination by its unfounded and damaging connection between mental illness and violence.”

Psych Central sums it up: “It stinks for everyone – especially patients.”

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What You Can Do Today to Help Stop HR 3717

As of April 20, HR 3717, the “Helping Families in Mental Health Crisis Act,” had 74 co-sponsors. So far, none of Oregon’s Representatives have signed on.

It is very important this bill gets as few as possible co-sponsors. Call your Representative today and ask him or her NOT to co-sponsor the bill. Here’s how:

1. To find your representative, go to http://www.opencongress.org/people/zipcodelookup and enter your address and/or Zip code. Click the name of your Representative, and look for the phone number of the D.C. office. You may have to scroll down.

2. When you call, tell the person answering the phone the following message (or write your own – just remember to keep it brief):

“I live in Representative (name)’s district. He (or she) should NOT cosponsor HR 3717 (Rep. Tim Murphy’s mental health bill) because it is bad for constituents. This bill promotes coercive treatment, increases stigma, weakens protections for vulnerable people, and terminates critical mental health programs that help people recover from serious mental illness.”

3. Ask the person that answers the phone to give your message to the staff member that handles health issues for the Representative.